22
Diagnosis
Table 4. Recommended Initial Laboratory Screening and
Other Studies in Persons with HIV
Test Comment(s)
Screening for Coinfections
Gonorrhea, chlamydia NAAT testing with sites based on exposure history
(e.g., urine, vaginal, rectal, oropharyngeal; 3 site
testing preferred for all patients).
Trichomoniasis In all persons who have vaginal sex.
Syphilis Using local protocol (either RPR or treponemal-
specific antibody tests).
Latent Mycobacterium tuberculosis Tuberculin skin test or IGRA. IGRA preferred if
history of BCG vaccination.
Varicella virus Anti-varicella IgG if no known history of
chickenpox or shingles.
Viral hepatitis A, B, and C HBsAg, HBsAb, HBcAb, HCV antibody, HAV
total or IgG antibody. If HBsAg+, or HBcAb
positive, order HBV DNA level. If HCVAb+,
order HCV RNA level and HCV genotype.
Screen for hepatocellular carcinoma for all adult
patients with cirrhosis and non-cirrhotic patients
with chronic HBV for an extended period.
Measles titer Adequate evidence of immunity includes
being born in the US before 1957, written
documentation of adequate vaccination, or
serologic evidence of immunity. Persons born in
the 1960's may have been vaccinated with a vaccine
other than MMR and may have waning immunity.
Patients may opt to receive a booster MMR
vaccine rather than check serolog y.
Tests at May Be Performed Under Certain Circumstances
Chest radiography For patients with evidence of latent M. tuberculosis
infection. Consider in patients with underlying
lung disease for use as comparison in evaluation of
future respiratory illness.
Cytolog y: Cervical and/or anal
Pap test
Cervical; anal if indicated. Abnormal results
require follow-up with colposcopy or high-
resolution anoscopy, respectively.
Glucose-6-phosphate
dehydrogenase
Screen for deficiency in appropriate racial or
ethnic groups to avoid use of oxidant drugs
including dapsone, primaquine, sulfonamides.
(cont'd)
